National AHEC Organization 2010 Annual Conference

Las Vegas NVJune 23, 2010

Mary Mitchell, Executive Director, Manhattan-Staten Island AHEC.

Susan Moreland, Executive Director, Northern Louisiana AHEC.

Richard Kiovsky M.D., Program Director, Indiana AHEC Program.

Richard Perry, Program Director, Oklahoma AHEC Program.

Purpose of Survey Introduction of Panel and First Thoughts Survey Results Group Breakout Groups Report Back Open Discussion and Next Steps

Responses = 89 Only 38% Response Rate

CD Tenure = 52% less than 5 years

Almost normal bell-shaped curve

Years Center Established: 75% > 5 years 55% > 10 years

Different response rates affected by # years Center in existence

Center Structure: 501c3 = 53% Hosted = 47%

Challenges often reflect type of Center Structure

Challenges in Relationship with Program Office = wide range, but a few issues predominate (> 50% of respondents.Revenue and Fundraising for CenterRevenue and Fundraising for State Challenges not the same as the areas that require interactionFew Challenges identified by Center Directors

Issues Requiring “Regular Interaction” with Program Office (> 50% or respondents)Technical Assistance/Data Program Outcomes (Deliverables)Legislative AdvocacyProgram PlanningProgress ReportsContract ManagementRenewal Applications

< 2 yrs. Experience 2-10 yrs Experience 11+ yrs Experience

Program Planning Program Outcomes Legislative Advocacy

Boards TA – Data Program Reports

Networking Renewal Applications

Fundraising Centers Fundraising Centers

Developmental Issues

Operational Issues System Issues

Challenges in relationship with PO increases with CD experience, especially in Operational and System issues

Interaction Increases Interaction Decreases

Renewal Application* Program Planning*

Legislative Advocacy* Budget Management~

Fundraising State~ Capacity Building~

Progress Reports~ Boards~

Program Outcomes~ Networking~

State Focus Center Focus

(Clearly * Trending ~)

Most Frequently Mentioned “Difficult Problems:Lack of Common/Stable Set

of Priorities 22%

Mentioned multiple times – how do we solve this issue?

Instability of Funding Re-authorization of $125 M is critical – do our legislators know?

Lack of Involvement/Leadership from Program Office

Why?

Lack of Communication and Punctuality of Information

Any best practices on this issue?

A number of CD expressed skepticism about truthfulness of survey responses & security

How does NAO encourage and support openness?

No challenges currently 16% Rare, but good!

“The Program Office wants to develop a system to distribute funds to the centers – problem is there is no method that is equitable. Holding new AHEC centers to higher standards than older ones just doesn’t work”

“Program Directors over the last 10 years have increasingly become more part-time, about 40% FTE. However, they often devote about 15% real time to the AHEC Program. At this time, we need committed leaders more than ever”

“It’s very difficult to serve 2 masters! As a non-profit 501c 3 with dwindling state and federal support, it’s very difficult to meet the mandates of the Statewide program submission at both the State and Federal levels.”

Program Office views relationship as top/down vs. collegial. Centers view PO relationship as support”

Responses = 43 83% Response Rate

PD Tenure = 52% <5 Years 24% >10 Years

Turn-over rate an issue

Years PO in Existence = 75% > 10 Yrs

AHEC Longevity

PD Previous CD Experience: 79% NOPD Previous AHEC Staff: 79% NO

What does this mean?

Program Office Structure: 501c 3: 30% Hosted: 26% Mixed: 44%

Each creates own set of challenges

Challenges in Relationship with CentersStatewide Revenue and fundraising: 63%Revenue/fundraising for CENTERS: 54%Program Outcomes (Deliverables/Perf. Meas): 42%Technical Assistance 37%Capacity Building (Board Dev. & Board Issues) 37%

Issues Requiring Regular Interaction with Centers Program Outcomes / Deliverables 81%Program Planning 81%Collaborations/Networking 79%Budget Management 72%Coordinating Progress Reports 72%Items seen as challenges are not those

requiring the most Interaction

Most Frequently Mentioned “Difficult Problems”Disagreement – Resistance

to Program Office Expectations or Goals 34%

Communication?Leadership Problems?No contractual Requirements?

Center and Host Agendas in conflict with Statewide Goals

What are the expectations – criteria for host organizations?Center dependence on PO

to secure FundingSustainability & Fund-raising, are we Trained for this?

Center delay in getting invoices to PO 29%

Multiple reasons?

“When a center is a 501c3, it takes the center board, center director, and the program office to make it their top priority to work together. Different agendas and accountability issues makes it hard to get things accomplished.”

“Centers think they are the entire program, can do whatever they want, and regard the PO as a nuisance.”

“Individual Centers do understand the larger picture of how the entire program operates within the state, but not every center is on board.”

“Centers expect the PO to provide for most or all of their financial needs and take variable responsibility for funding their own projects, don’t do advance planning for sustainability of funding, programs and staff.”

No Prior AHEC Experience Prior AHEC Experience

Program Outcomes Budget Management

Program Planning Program Outcomes

Networking Program Planning

Technical Assistance – Data Networking

Grant Writing

Progress Reports

75% of respondentsVery Little Difference

Rate 1-5,with 1 being “hands off” and 5 being “hands on,” the level of collaboration your center/program has with your program/centers on the following issues:

(%=very or somewhat “hands on”, rating 4 or 5)

Issue Centers Program

Progress Reports

27% 65%

Revenue/Statewide

24% 62%

Federal/State Dollar Allocation

47% 62%

Issue Center ProgramProvide Timely Information 37% 60%

Competitive Renewal 47% 59%

Program Outcomes 36% 58%

Technical Assistance (Data) 36% 56%

Legislative Advocacy 31% 53%

Contract Management 31% 46%

Collaboration/Networking 23% 45%

Grant Writing/Management 16% 43%

Issue Center ProgramRevenue/Centers 24% 38%

Capacity Building

10% 31%

AHEC Boards 25% 30%

Budget and Budget Management

21% 30%

Program Office Staff 29% na

Considerable Agreement by PD and CD as to what areas require most regular interaction and most challenge in interaction

Areas requiring Regular Interaction are NOT the areas of most Challenge

CD’s perspective over time change: Developmental, Operational and Systemic

PD’s believe they are more collaborative in their interactions than CD’s report

Little difference in PD perceptions of challenges and interactions between those with or without prior AHEC experience

Low Response Rate by CD’s may skew results